A one-step enzyme immunoassay for human manganese superoxide dismutase with monoclonal antibodies.

A one-step enzyme immunoassay for the determination of manganese superoxide dismutase in serum has been developed with two kinds of monoclonal antibodies. Proposed method had high sensitivity (assay range, 0.4-200 ng/ml), good recovery (recovery percentage, 102.9-106.2%) and reproducibility (intraassay, C.V. = 1.87-3.66%; interassay, C.V. = 3.03-10.4%). From these results, it is possible to apply this method to routine clinical analysis and biochemical research with various purposes.

Inhibitory effect of propylthiouracil on the development of metabolic tolerance to ethanol.

Chronic ethanol administration (4-5 weeks) to female spontaneously hypertensive (SH) rats led to a marked increase in the rate of ethanol metabolism. This was accompanied by an increase in hepatic alcohol dehydrogenase (ADH) and by an increase in the rate of oxygen consumption in perfused livers of these animals. Treatment with the antithyroid drug 6-n-propyl-2-thiouracil (PTU) during the last 9 days (40 mg/kg/day) of the chronic administration of ethanol reduced hepatic oxygen consumption, resulting in a net diminution of the metabolic tolerance to ethanol, despite a further elevation in ADH activity. In these animals, microsomal ethanol-oxidizing system (MEOS) activity was not affected by chronic ethanol administration or by treatment with PTU. Data strongly suggest that in the female SH rat all the metabolic tolerance to ethanol proceeds via the ADH pathway, and that the increase in hepatic oxygen consumption is more important in the development of metabolic tolerance to ethanol than the increased ADH levels.

Extrarenal Wilms' tumor in the adult patient. A case report and review of the world literature.

A case of an extrarenal Wilms' tumor arising in the retroperitoneal region of a 49-year-old male is reported. A review of the world literature indicates that the incidence of the tumor arising in the extrarenal region is extremely rare. A total of 14 cases have previously been reported, but the number of cases that occurred in adult patients is only 2. The clinical and pathologic features are briefly discussed.

Determination of mitochondrial aspartate aminotransferase in serum.

Two specific and sensitive immunoassay methods for the determination of mitochondrial aspartate aminotransferase (m-AST) are described. One is a sandwich enzyme immunoassay which measures immunologically active m-AST using polystyrene balls coated with anti-m-AST antibody and peroxidase-labelled anti-m-AST antibody as the second antibody. The detection limit of this assay was 10 micrograms/l. The other is a paper disk method which measures catalytically active enzyme bound to anti m-AST antibody-conjugate paper disks. The calibration curve was linear up to 250 U/l. These assay methods were used to monitor the level of m-AST in serum. From measurements obtained by both methods, the correlation between the concentration of m-AST protein and its activity was poor (liver diseases, r = 0.539; myocardial infarction, r = 0.774) confirming that an inactive form of m-AST exists in serum, and that the specific activity of serum m-AST differs in individual diseases.

Significance of serum gamma glutamyl transpeptidase as a marker of alcoholism.

To study the effect of chronic ethanol administration on the activity of gamma glutamyl transpeptidase (GGTP) in various tissues, female rats were pair-fed liquid diets with 36% of total calories either as ethanol or as isocaloric carbohydrate (controls). Six weeks of ethanol feeding resulted in a significant increase of cytochrome P450 content. Hepatic microsomal GGTP activity was almost doubled after ethanol feeding whether expressed per g of liver or per mg of microsomal protein. Furthermore, intestinal GGTP activity was significantly enhanced after ethanol, whereas there was no change in the enzyme activity in either kidney or pancreas. There was a concomitant elevation of plasma GGTP activity. Phenobarbital administration to rats resulted in an enhancement of GGTP activity in the liver whether given orally or intraperitoneally. In addition, intestinal GGTP activity after oral phenobarbital was also significantly increased, although its activity after intraperitoneal administration was not enhanced. These results suggest that enhanced hepatic and intestinal GGTP activities may contribute, at least in part, to an increased level of serum GGTP frequently seen in chronic alcoholics.

Potentiation of halothane hepatotoxicity by chronic ethanol administration in rat: an animal model of halothane hepatitis.

To determine if chronic ethanol administration modifies the effect of halothane on the liver, fourteen male Wistar rats were pair-fed nutritionally adequate liquid diets containing either ethanol (36% of calories) or isocaloric carbohydrate (controls) for 6 weeks. After halothane anesthesia of these animals under different oxygen concentration, the livers were examined light microscopically as well as biochemically. The livers from rats fed ethanol which received halothane at low oxygen concentration showed multifocal or patchy necrosis primarily in the centrilobular regions with parenchymal lipid accumulation, whereas no such lesions were not observed in pair-fed controls. Hepatic necrosis was also seen after halothane anesthesia even at ambient oxygen concentrations, although the degree of necrosis was much milder. Hepatic microsomal cytochrome P450 content was increased by 30% after ethanol but was decreased following halothane anesthesia. These data suggest that halothane is hepatotoxic to liver of rats chronically pretreated with ethanol, especially under hypoxic condition.

Alterations in hepatic delta-aminolevulinic acid synthetase and heme oxygenase activities after chronic ethanol consumption in rats.

In the present study, the effect of chronic ethanol consumption in rats on the hepatic heme metabolism was investigated. Male Wistar rats were fed a nutritionally adequate liquid diet containing ethanol as 36% of the total calories for 5 weeks. After an overnight fast, the livers were excised and centrifuged to obtain mitochondrial and microsomal fractions. Chronic ethanol feeding of rats resulted in about 19% hepatomegaly as represented by the increased liver/body weight ratio. There was no difference in the mitochondrial protein content between the ethanol-treated and control rats, but the microsomal protein content was significantly increased in the ethanol-treated rats. Hepatic microsomal content of cytochrome P-450 (P-450) was markedly enhanced by chronic ethanol ingestion. Microsomal contents of cytochrome b5 (b5) and total heme were also increased to a lesser extent. After chronic ethanol abuse, the hepatic activity of delta-aminolevulinic acid (ALA) synthetase, which is a rate-limiting enzyme for heme production, was significantly increased and that of the heme oxygenase was slightly increased. These data indicate that ALA synthetase activity is induced by the negative feedback mechanism in order to compensate the depletion of heme caused by the utilization of heme for P-450. It is also speculated that, in response to excessive production of heme as described above, heme oxygenase activity is secondarily induced to regulate the amount of heme.

Mild but prolonged elevation of serum angiotensin converting enzyme (ACE) activity in alcoholics.

Serum activity of angiotensin converting enzyme (ACE) was serially measured in 47 hospitalized chronic alcoholics with liver disease. Compared to healthy controls, ACE activity, on admission, in the serum of alcoholics was significantly elevated (42.5 +/- 16.6 U/ml vs. 32.4 +/- 9.6 U/ml; p less than 0.005). About 36% of the patients had an elevated ACE level exceeding an upper normal value of 42 U/ml (mean +/- SD). In contrast to the rapid normalization of such enzymes as aspartate transaminase (AST), alanine transaminase (ALT) and lactic dehydrogenase (LDH) which represent parenchymal liver cell injury, the activity of ACE remained elevated over a period of 4 weeks even with abstinence. The serum level of ACE was significantly correlated with levels of alkaline phosphatase, gamma-glutamyltranspeptidase and monoamine oxidase, but not with those of AST, ALT and LDH. These data suggest increased ACE activity in alcoholics may be related to the influence of chronic consumption of alcohol on hepatic nonparenchymal systems.

Increase in mitochondrial GOT (m-GOT) activity after chronic alcohol consumption: clinical and experimental observations.

In order to clarify the origin and the mechanism of increased serum activity of glutamic oxalacetic transaminase (GOT) in chronic alcoholics, clinical and experimental investigations were carried out. Mitochondrial (m-GOT) and cytosolic GOT (c-GOT) isoenzymes were separated chromatographically by using a mini-column packed with Sephadex A50. Sixty percent of 63 alcoholics had elevated serum GOT. The m-GOT activity in alcoholics with total serum GOT activity of over 50 Karmen Units was 17.2 +/- 1.6 K.U. and the m-GOT/GOT ratio was the highest when compared to those in non-alcoholic liver diseases. In in vitro study, six hours of incubation of isolated hepatocytes from rats fed ethanol chronically resulted in an increased leakage of m-GOT into the incubation medium and also showed a tendency of a higher m-GOT/GOT ratio than that from control rats. The m-GOT activity thus released into the medium showed a highly significant inverse correlation with the viability of hepatocytes. These data suggest that m-GOT substantially contributes to an increased serum GOT often observed in chronic alcoholics.

Studies on vocal fold injection and changes in pitch associated with alcohol intake.

The current study was carried out with particular emphasis on the association between phonetic function tests and alterations in the appearance of the hypopharyngeal and laryngeal mucosa, such as capillary dilatation, edema, and vocal fold injection after alcohol intake. The results demonstrated the occurrence of previously unrecognized pathophysiological changes associated with synchronous phonetic functions in the vocal pathway after alcohol intake. Serum ethanol and aldehyde concentration levels were evaluated hourly for 2.5 h after ingestion of alcohol. When an electronystagmogram showed the typical pattern of alcohol intake, the study was initiated. Occasionally, rhinography was performed on subjects complaining of a stuffy nose after alcohol intake.

[Serum type III procollagen peptide in diagnosis of lung fibrosis due to silicosis and bleomycin toxicity].

Early diagnosis of lung fibrosis has been hampered by the lack of a simple, convenient and specific test. Measurement of serum type III procollagen peptide (Pro (III)-N-P) by the method originally developed by Rohde et al. has been shown to be useful for the evaluation of hepatic fibrosis. The present study, therefore, was carried out to investigate the usefulness of the measurement of Pro (III)-N-P in 24 patients with lung fibrosis due to silicosis, and in 7 patients with malignant lymphoma treated with bleomycin, antitumor antibiotic which has the adverse effect of producing fibrosis in the lung. The normal value of the peptide in adults was 8.60 +/- 2.35 ng/ml (mean +/- SD; n = 68) and the normal upper level was set at 13.4 ng/ml (mean +/- 2SD). Patients with silicosis had significantly but not extremely high levels of the peptide and 25% of the patients showed abnormally high values. The level of Pro (III)-N-P was associated with neither physical findings, chest X-p findings nor pulmonary function test results. Three of 7 patients showed increased levels during treatment with bleomycin. In one case, a total dose of 120 mg of bleomycin for over a period of 14 months markedly increased the level of the peptide. These observations suggest that the determination of Pro (III)-N-P may be useful for the detection of lung fibrosis.

Glutathione contents in rat livers after acute and chronic exposure to ethylene oxide.

Wistar rats were subjected to a 6 hr exposure to ethylene oxide once at the concentration of 500 ppm, 3 times a week for 12 weeks as a chronic experiment. Hepatic glutathione contents were determined after these treatments. The specific content of reduced form of glutathione (GSH) in the rat livers of chronic exposures was 28.9 nmoles/mg protein, which is not significantly different from that of control group. On the other hand, the hepatic content of GSH in rats subjected to a 4 hr exposure to ethylene oxide at a concentration of 2500 ppm decreased markedly to the levels of 5% of control value. The present results suggest the involvement of glutathione, at least in part, in the detoxication of ethylene oxide.

[Clinical experiences of LAK therapy in patients with hepatocellular carcinoma].

A patient with hepatocellular carcinoma (HCC) was treated with newly established adoptive immunotherapy using LAK cells (LAK therapy) together with transcatheter arterial embolization therapy (TAE). This patient responded well, and the therapeutic efficacy still continues 6 months after the therapy. Since the efficacy of LAK therapy does not last long, it is recommended that LAK therapy should be employed in combination with such therapeutic maneuvers as TAE or anticancer drugs in patients with HCC.

[Serum type III procollagen peptide in diagnosis of lung fibrosis due to silicosis and bleomycin toxicity].

Early diagnosis of lung fibrosis has been hampered by the lack of a simple, convenient and specific test. Measurement of serum type III procollagen peptide (Pro (III)-N-P) by the method originally developed by Rohde et al. has been shown to be useful for the evaluation of hepatic fibrosis. The present study, therefore, was carried out to investigate the usefulness of the measurement of Pro (III)-N-P in 24 patients with lung fibrosis due to silicosis, and in 7 patients with malignant lymphoma treated with bleomycin, antitumor antibiotic which was the adverse effect of producing fibrosis in the lung. The normal value of the peptide in adults was 8.60 +/- 2.35 ng/ml (mean +/- SD; n = 68) and the normal upper level was set at 13.4 ng/ml (mean +/- 2SD). Patients with silicosis had significantly but not extremely high levels of the peptide and 25% of the patients showed abnormally high values. The level of Pro (III)-N-P was associated with neither physical findings, chest X-p findings nor pulmonary function test results. Three of 7 patients showed increased levels during treatment with bleomycin. In one case, a total dose of 120 mg of bleomycin for over a period of 14 months markedly increased the level of the peptide. These observations suggest that the determination of Pro (III)-N-P may be useful for the detection of lung fibrosis.

[Epidemiological study on alcohol consumption and physical health in the Kitakyushu area with special reference to industrial structure].

Kitakyushu city is characterized by the following aspects, that is a large amount of alcohol consumption relative to other cities high death rate of liver cirrhosis and chronic liver diseases many recipients of the Daily Life Security a large population of aged people. This study was carried out to investigate the interrelation of industrial structure and drinking status of people living under these situations in Kitakyushu. The close association between drinking and liver diseases was found. Furthermore, a large proportion of drinkers were recipients of the Daily Life Security and this is one of the problems to be resolved. It also became clear that it is not easy to stop drinking for habitual drinkers in spite of the presence of liver diseases and the loss of feeling of satisfaction with life which may be triggered by retirement from job possibly hampers them from problem drinking. With an increase of a population of aged, an increase of alcoholism among them may cause serious, local but social problems. These problems may not be resolved only by the effort of clinical medicine, also macroscopical point of views through social structure, industrial structure, a policy of welfare, public health services etc. are required. A part of the study was presented at the 17th, 18th and 19th Conference of Japanese Medical Society of Alcohol Studies.

[Serum type III procollagen peptide in patients with pneumoconiosis].

Early diagnosis of lung fibrosis has been hampered by the lack of a simple, convenient and specific method. Recently Rohde et al. developed an assay method for Type III procollagen peptide. Type III procollagen peptide, an extension peptide released during the biosynthesis of collagen Type III, has been known as a good marker for hepatic fibrosis. Therefore, we applied this assay to the patients with idiopathic pulmonary fibrosis, lung fibrosis in collagen disease and silicosis. And also we measured the serum level of the peptide in the healthy workers being exposed to silica. Normal value of the peptide in adults was 8.3 +/- 2.6 (mean +/- SD; n = 32) ng/ml. The upper value over mean + 2SD, 13.4 ng/ml, was regarded as abnormal value. Six patients with idiopathic pulmonary fibrosis, and lung fibrosis in collagen disease showed a significant increased level of 19.0 +/- 9.6 ng/ml (P less than 0.02). Four of 6 patients had abnormal high values. On the other hand, the patients with silicosis had not so high levels of peptide (12.6 +/- 6.5 ng/ml; n = 24; P less than 0.01), but 25% of the patients showed abnormal values. There were 2 cases among 19 healthy workers being exposed to silica who revealed slight abnormal values, 15.6 and 16.7 ng/ml. These observations suggest that the assay has a prognostic value for lung fibrosis and also is useful for the early detection of active lung fibrosis in the workers, even though Type III procollagen biosynthesis is already low in the late stages of silicosis.

[Rupture of hepatocellular carcinoma with multiple pulmonary metastasis successfully treated by transcatheter arterial embolization (TAE) of tumor: a case report].

A 66-year-old woman was hospitalized in a state of shock with rupture of hepatocellular carcinoma and multiple pulmonary metastasis. Her bleeding was successfully controlled by emergency transcatheter arterial embolization with Lipiodol (Lp-TAE). Treatments with UFT, OK-432 and two additional Lp-TAE caused the disappearance of pulmonary metastasis with AFP levels decreased and natural killer cell activity increased. The patient died one and a half years after the emergency Lp-TAE. The disappearance of pulmonary metastatic lesions seemed to be caused by improvement of the patient's immunity, which related to the regression of primary tumor after Lp-TAE. It was suggested that Lp-TAE is worth undertaking even in rupture of hepatocellular carcinoma with remote metastatic lesions.

[An experimental study on the severe type of alcoholic liver disease--a pathogenetic role of potentiated activation of complement system by endotoxin after chronic ethanol consumption].

Endotoxemia frequently appears in severe type of alcoholic liver disease. However, we have little knowledge how endotoxin influences the progression of alcoholic liver injury. Thus, to study the causal mechanism for the progression to the severe type of alcoholic liver diseases, endotoxin (0.2 mg/100 g BW, E. Coli O26:B6) was intravenously injected in chronic ethanol-fed rats and controls, and then, rats were sacrificed after 16 hours of endotoxin treatment. The elevation of serum GOT and GPT activities induced by endotoxin was significantly higher in chronic ethanol-fed rats than controls, and these biochemical changes were well correlated with the grade of necrosis of liver histology. Furthermore, in chronic ethanol-fed rats, endotoxin treatment tremendously increased blood BUN and creatinine levels and produced the degeneration of renal tubuli with neutrophil infiltration into glomerulus. These experimental findings are very similar to the severe type of alcoholic liver disease. On the other hand, endotoxin significantly decreased serum values of CH50 in chronic ethanol-fed rats, but not in controls. Such alterations of CH50 induced by endotoxin were well correlated with the several parameters indicating the injury of liver and kidney. Therefore, the present study may indicate that chronic ethanol ingestion aggravates endotoxin-induced organ injury, and that the activation of complement system may associate with such progression of organ injury.

[Role of singlet oxygen in pathogenesis of liver injury in rats treated with D-galactosamine].

A study was conducted to elucidate the possible role of singlet oxygen in pathogenesis of D-galactosamine-induced liver injury. Tissue and plasma levels of singlet oxygen were determined with chemiluminescence analysis. Following results were obtained: 1) Chemiluminescence as well as malondialdehyde, which is regarded as one of terminal products of lipid peroxidation, significantly increased in the liver and plasma of rats treated with D-galactosamine. 2) Elevation of plasma GPT and total bilirubin was also observed in rats with D-galactosamine-induced liver injury. Histological examination of the liver revealed submassive hepatic necrosis. 3) Administration of vitamin E, a radical scavenger of singlet oxygen, significantly inhibited the increases of chemiluminescence and MDA in the liver and plasma as well as the elevations of GPT and total bilirubin in the plasma. Histological changes of the liver were also found to improve significantly by vitamin E administration. In conclusion, singlet oxygen seems to be definitely involved, at least in part, in pathogenesis of liver damage induced by D-galactosamine. In addition, inhibition of the liver injury is possible, to some extent, by administration of vitamin E, one of the potent radical scavengers of singlet oxygen.

[Alteration of prostaglandin metabolism in alcoholic liver disease: its association with platelet dysfunction after chronic alcohol ingestion].

Recently, hepatic microcirculation has been focused on as an important pathogenic factor in progression of alcoholic liver disease (ALD). Therefore, blood levels of several prostaglandins, which are associated with organ microcirculation, were determined in various liver diseases, including ALD. Blood thromboxane B2 (TXB2) level was significantly increased in ALD, when compared to other types of liver diseases, whereas both 6-keto prostaglandin F1 alpha (6-keto PGF1 alpha) and prostaglandin E were not changed. These consequences resulted in the imbalance of 6-keto PGF1 alpha to TXB2, which might promote platelet aggregation and blood vessel contraction. Indeed, the increase of beta-thromboglobulin and platelet factor 4 in blood was observed in ALD. Furthermore, in ALD, the rate of arachidonate-induced platelet aggregation was prominently enhanced, and malondialdehyde production in platelet, which was well correlated with blood TXB2 levels, significantly increased. Thus, the present study may indicate that, in ALD, hyper-aggregability of platelet is produced, because of the derangement of prostaglandin metabolism and platelet dysfunction.